Myomectomy

Uterine leiomyomas, more commonly known as fibroids, are one of the most common gynecologic issues for women. They can cause pelvic pain, bleeding and can contribute to infertility.

Some women with fibroids have a hysterectomy, which is a surgery to remove the uterus, so fibroids are no longer an issue. However other women with fibroids do not want a hysterectomy because they want to be able to have children one day. For these women, myomectomy, a surgery to remove these fibroids, can be a good option.

Things to Consider

Before considering myomectomy, your gynecologist will discuss your unique circumstances, as well as the benefits and possible risks of the procedure:

• Your chances of pregnancy may be improved, but are not guaranteed, since fibroids can grow back
• If your goal is to become pregnant, you should try to conceive as soon as safely possible after a myomectomy
• After myomectomy, if you become pregnant, you may need a cesarean section for delivery

Prior to myomectomy, we may recommend a medication that lowers your estrogen levels and helps shrink fibroids. This may also reduce blood loss from your myomectomy. However, after you stop taking it, your fibroids may grow back.

About the Surgery

There are several different surgical options for myomectomy, and your gynecologist will determine which one is best for you depending on the size, location and number of fibroids, as well as your unique health and circumstances:

• Hysteroscopy: An outpatient procedure that involves inserting an instrument through the vagina and into the uterus, so no incisions are needed.
• Laparoscopy: This procedure uses a lighted viewing instrument and one or more small incisions in the abdomen. It may be performed as an outpatient procedure or in a hospital.
• Laparotomy: This option is for removing larger fibroids. It requires a larger incision in the abdomen and generally patients stay in the hospital for 1 to 4 days after the surgery to recover.

After the Surgery

After your surgery, you will go to a recovery room and a clinician will monitor your vital signs, such as blood pressure, pulse and breathing. Once you are stable and alert, you will go to your hospital room to continue recovering.

At home, if you had a procedure that involved an incision, you will need to make sure it stays clean and dry and follow the bathing directions your gynecologist provides. They will also give you other instructions, such as to avoid standing for more than a few minutes at a time for the first few days. Depending on the type of procedure you had, you will be able to return to work or regular activity within 2 to 6 weeks.